Gatekeepers as Care Providers: The Care Work of Patient-centered Medical Home Clerical Staff

Samantha L. Solimeo, Sarah Ono, Kenda R. Stewart, Michelle A. Lampman, Gary E. Rosenthal, Greg L. Stewart

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

International implementation of the patient-centered medical home (PCMH) model for delivering primary care has dramatically increased in the last decade. A majority of research on PCMH's impact has emphasized the care provided by clinically trained staff. In this article, we report our ethnographic analysis of data collected from Department of Veterans Affairs staff implementing PACT, the VA version of PCMH. Teams were trained to use within-team delegation, largely accomplished through attention to clinical licensure, to differentiate staff in providing efficient, patient-centered care. In doing so, PACT may reinforce a clinically defined culture of care that countermands PCMH ideals. Such competing rubrics for care are brought into relief through a focus on the care work performed by clerks. Ethnographic analysis identifies clerks' care as a kind of emotional dirty work, signaling important areas for future anthropological study of the relationships among patient-centered care, stigma, and clinical authority.

Original languageEnglish (US)
JournalMedical Anthropology Quarterly
DOIs
StateAccepted/In press - 2016

Fingerprint

Patient-Centered Care
gatekeeper
staff
Anthropology
emotional work
Veterans
Licensure
Staff
Gatekeeper
Primary Health Care
Research

Keywords

  • Department of Veterans Affairs
  • Ethnography
  • Medical home
  • Medical receptionists
  • Primary health care

ASJC Scopus subject areas

  • Medicine(all)
  • Anthropology
  • Visual Arts and Performing Arts

Cite this

Gatekeepers as Care Providers : The Care Work of Patient-centered Medical Home Clerical Staff. / Solimeo, Samantha L.; Ono, Sarah; Stewart, Kenda R.; Lampman, Michelle A.; Rosenthal, Gary E.; Stewart, Greg L.

In: Medical Anthropology Quarterly, 2016.

Research output: Contribution to journalArticle

Solimeo, Samantha L. ; Ono, Sarah ; Stewart, Kenda R. ; Lampman, Michelle A. ; Rosenthal, Gary E. ; Stewart, Greg L. / Gatekeepers as Care Providers : The Care Work of Patient-centered Medical Home Clerical Staff. In: Medical Anthropology Quarterly. 2016.
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